Having gloated about the wonders of the new stoma on my 'Stoma #2' page, we did end up having some problems: The flange on the outside was very rigid, and was rubbing and causing irritation. We went back to the manufacturers and asked for the silicon to be made more flexible, and we also decided to make the inside flange thinner as at its current thickness it was taking up a lot of her windpipe, and sat very close to the back of it, so looking directly down the stoma hole I could see the back of her wind-pipe very close to the flat edge of the stoma, not leaving as much space as I'd like.
On getting this new design, our vet agreed to swap it out for the old one, but found that with the new flexibility and thinner flange, there was not enough strength in the flange to keep it in the hole, and it came out quite easily. And as such he simply turned it around so the thin side was now on the outside; this would fix the rubbing problem but did not really solve the issues of 'clearance'. It was still an improvement though.
However, whenever Heidi yawned, or she scratched at her stoma too much causing swelling, this thinner outside flange would yield to the pressure of the surrounding flesh and sank back into the hole, which has caused some scary moments when Heidi couldn’t breath and I had to use a crochet hook to pull it forward again, saving her life. (crochet hooks are now my most important tool in my 'trach-box'. I am NEVER without one about my person.)
I blamed this on the thinness of the outer flange vs. the thickness of the inner one, and after yet another scare when Heidi couldn’t breathe we went to ask to try the stoma around the other way (as it was better than doing nothing as Heidi had now had two very near misses) believing that the hole would have healed to fit this stoma and would hold in place, and also having been told that she would still have a viable trach hole without a stoma. (The hole in the trach is permanent, its the outer skin that causes the problems.) Having had the stoma swapped around, and being told it seemed secure, we took her home, marvelling at her new wonderfully easy breathing, and feeling pretty optimistic.
Later that day, I heard loud wheezing: I ran to her, to find there was no stoma in the hole, and she could not breathe! I instantly got my crochet hook, thinking she had sucked it in as I couldn’t see the stoma, and fished about for it..nothing: I tried the long tweezers I also keep in my emergency trach-box...nothing...finally I put my little finger in to feel how far down it was.....nothing: It must have come out, (it had rolled under the bed where I had left her, I found out later).
Now I knew it was not lodged in her throat, I pulled at the skin either side of the stoma, this cleared it just enough to get some air in, not much, her tongue was blue, but she was staying conscious. I called my husband, who was at work, and he came home. He made it in about 8 minutes, although it felt like a lifetime!
We had some thin plastic tube from my husbands home brewing hobby, and he cut a length off for me, it just fitted in her hole, and this bought us the time to get her to the local vets. Once there, she was given oxygen, and sedated. My husband had brought along the latest stoma design (as we did not really trust the new stoma) and he got the local vet (not our specialists) to cut the end off a syringe that would fit into her hole, and he forced the new stoma into this, so we could essentially inject it into her neck: (this is also our idea, invented after we were told there was no way to get our new stomas into a small hole in a dogs neck: I think my Husband watches too much MacGyver!)
This worked, and with more oxygen, she recovered. I must just add that my Husband actually performed this latest 'surgery', and he should get a medal for staying calm enough to do this on the fly! I was a mess. I think I even asked the vet for some sedation too!
